OBJECTIVE:To observe the hemostasis effect of combination of repilase and nitroglycerine against Emptysis.METHODS:90patients with Emptysis were randomly divided into treatment group and control group.The treatment group were treated with Reptilase together with nitroglycerine while the control group were treated with conventional hypophysin therapy.RESULTS:The total effective rate of hemostasis against hemoptysis was95.6%in the treatment group,which ex-celled the control group which has a total effective rate of66.7%.No significant adverse effect was found in the treatment group,which had a significant difference(P

Objective To assess the effect of intraarterial washout with UW solution and tanshinone Ⅱ A for skeletal muscle preservation during ischemia and reperfusion.Methods Ischemic rat limbs were perfused with UW solution or UW solution plus tanshinone Ⅱ A (0.05,0.1 and 0.2 mg/ml) for 0.5 h before reperfusion; controls received no perfusion.Serum CPK,LDH,and AST were measured pre-ischemia and after reperfusion (2 h,4 h,and 6 h).Muscle water content,MDA,SOD,ATPase were assessed pre-reperfusion and after 6 h reperfusion.ICAM-1 was detected after 6 h reperfusion.Results Intraarterial washout with UW and UW + T could inhibit the express of ICAM-1 in skeletal muscle.The serum levels of CPK,AST,and LDH in UW group were significant lower than those in control group after 2 h of reperfusion,but no difference was observed between UW group and control group after 4 h and 6 h of reperfusion.After 4 h of ischemia,there were significant differences in water content,MDA,SOD,and ATPase in skeletal muscle between UW group and control group,but no difference was found after 6 h of reperfusion.In contrast,all parameters of laboratory test and biochemical analyzing in UW + T(0.05,0.10,and 0.20 mg/ml) groups were significantly different from those in control group at corresponding reperfusion period.Conclusion Intraarterial washout with UW solution is effective in preserving skeletal muscle integrity against I/R insult.Tanshinone Ⅱ A as a beneficial adjunct to UW solution improves the protective effect of UW solution for ischemic skeletal muscle.To better preserve ischemic skeletal muscle,an appropriate dose of tanshinone Ⅱ A (0.1 or 0.2 mg/ml)added to UW solution is required.

Objective To discuss the clinical value of u ltrasound-guided stereotactic biopsy and excision using the Mammotome system in the treatment of benign breast lesions. Methods A retrospecti ve analysis was made on the efficacy of ultrasound-guided Mammotome biopsy and e xcision in the management of 61 patients clinically diagnosed as having benign b reast lesions between October 2001 and October 2002. Results T he lesions were histologically confirmed as fibroadenoma in 51 patients and mast opathia in 10 patients. The operative time was 20.6?4.1 min. All procedures w ere performed smoothly. Of the 61 patients, no infection or breast deformity occ urred on short-term follow-up examinations (1 month) except for mild subcutaneou s hemorrhage in 3 patients, and no obvious scarring was seen on long-term follow -up (2 years). Recurrence was found in only 2 patients. Conclusions Treatment of benign breast diseases by the Mammotome system can offer comp lete excision of the lesion, minimal invasion, a low recurrence rate, and good c osmetic outcomes.

Objective To investigate the expression pattern of skeletal muscle specific miR-206,myogenesis related myoD which change with time in dcnervated muscle atrophy rats.Methods From June,2015 to January,2016,40 SPF sprague-dawley rats were equally classified into 5 groups randomly according to standard settled before,5 groups were separately defined as denervated 0d group,denervated 1d group,denervated 7d group,denervated 14d group,and denervated 28d group.Each group contained 8 rats.The rats atrophy models were established by cutting sciatic never on left side.According to the different denervated time,the gastrocnemii on both sides were obtained under anesthesia,respectively.The wet weight ratio of two compared gastrocnemii were measured,and the gastrocnemii transection was observed by HE stain,measured the expression of myoD protein by western blot,obtained the expression of miR-206,myoD mRNA by qPCR.Results According to our study on rats denervated atrophy models,the wet ratio of compared gastrocnemius would decrease rapidly,by HE stain,decease of cross sectional area in muscle fiber was observed as well as degeneration.Collagen fibers hyperplasia appeared and increased with time change.Wet ratio and transaction aera ratio of group Od,1d,7d,14d,28d were 0.99±0.04,0.92±0.07,0.68±0.11,0.39±0.06,0.27±0.07 and 0.99±0.02,0.96±0.04,0.51±0.09,0.34±0.08,0.23±０.03 respectively,difference between experimental groups and control group were statistically significant (P＜ 0.05),the differences between each experimental groups were also statistically significant (P＜ 0.05).After qPCR test of miR-206,myoD mRNA expression,it was found that their expression patterns were similar,miR-206,myoD mRNA increased at first and would reach the expression peak at the 7 th day,after that their contents decreased but still higher at the 14th day when compared with that at the 1 st day.Their expression of group 0d,1 d,7d,14d,28d were 0.24±0.06,0.34±0.04,0.68±0.04,0.49± 0.07,0.25±0.03 and 0.41 ±0.06,0.49±0.09,0.93±0.06,0.66±0.03,0.39±0.04,respectively.All experimental groups were statistically significant different when compared with 0d group except 1d group (P＜ 0.05),the differences between each experimental groups were also statistically significant(P＜ 0.05).The protein expression of myoD was also measured by western blot test,which showed nearly the same expression pattern as the mRNA expression pattern.After injury,the protein expression increased and reached the expression peak at the 7th day.The relative expression of myoD of group 0d,1d,7d,14d,28d measured by grey ratio were 1.03±0.05,1.06±0.06,1.42±0.10,0.66±0.13,0.24±0.07,respectively.The difference between experimental groups and control group were statistically significant (P ＜ 0.05),the differences between each experimental groups were statistically significant (P ＜ 0.05) as well.Conclusion The degree of muscle denervation atrophy was related to the denervated duration in rats.The expression regulation of miR-206 and myoD in gastrocnemius was similar during the muscle denervation atrophy,which suggesting having internal relationship between miR-206 and myoD.

10.3969/j.issn.2095-4344.2013.24.001

Objective To investigate the efficacy of frontoparietal drill versus parietal drill in the burring hole and drainage for chronic subdural hematoma(CSDH),and provide an evidence for clinical application.Methods A total of 82 patients with CSDH from January 2013 to January 2016 in our hospital were randomly divided into observation group and control group.The observation group chose frontoparietal drill which located at the front 1/4 point at the axial view with the thickest hematoma.Control group chose parietal drill which nearby the parietal tuberodties at the axial view with the thickest hematoma.The postoperative residual hematoma volume,intracranial gas volume,recurrence rate,neurologic function and mental state between two groups were compared.Results The postoperative residual hematoma volume,intracranial gas volume,the recurrence rate and CSS were lower compared with the control group,the differences were significant(P<0.05).The MMSE score of observation group were higher that of the control group,the difference was significant(P<0.05).Conclusion The frontoparietal drill has a better effect to remove the hematoma and promotes neural functional recovery.

Objective To investigate the application of hypocaloric parenteral nutrition in postoperarive elderly patients with gastric cancer. Methods 59 elderly patients aged 60- 79 years with gastric cancer after operation were randomly assigned to receive 84 kJ · kg -1.d -1 hypocaloric parenteral nutrition (29 cases) and 126 kJ · kg-1 · d -1 standard-calorie parenteral nutrition (30cases),totally 6 d from postoperative 2 d. Complications, serum proteins, immune function,inflammation,blood glucose, liver function and recovery time of gastrointestinal function were observed during nutritional support. Results The postoperative complication rate were 37.9％(11/29) in hypocalorie group and 43.3 ％ (13/30) in standard calorie group ( P＞0.05),mainly pulmonary infection.There were no ditferences in levels of serum albumin,total protein and prealbumin between two groups at postoperative 3 d and 6 d (P＞0.05).Peripheral blood lymphocytes and T lymphocyte subsets CD3+,CD4+,CD4+/CD8- ratio were decreased after sugery,but CD8 1 values increased in two groups (P＞0.05).C reactive protein was increased significantly at postoperative 3 d compared with preoperation,and decreased at 6d than 3 d (P＞0.05).Blood glucose was decreased gradually at 3 and 6 d (P＞0.05).Postoperative liver function paraneters were elevated,no difference was found at 3 d (P＞0.05),and continued to rise at 6 d in standard calorie group than in hypocalorie group (P＜0.05). There was no difference in times of aerofluxus and cacation after operation between hypocalorie and standard calorie groups (P＞0.05). Conclusions Hypocaloric parenteral nutrition is a safe and effective method for nutrition support in postoperative elderly patients with gastric cancer.

Objective:To explore the causes and preventive measures of early complications after free gracilis muscle transfer in reconstruction of brachial plexus injury, and to improve the postoperative function of the transferred gracilis muscle.Methods:Patients were recruited from August, 2005 to December, 2016. All 111 patients of brachial plexus injury underwent reconstructive surgery using 122 free gracilis flaps. Early postoperative complications, including recipient site, donor site and systemic complications, were closely observed and recorded. Outcome measurements included incidence and timing of flap compromise, type of flap compromise, causes of vascular occlusion and salvage rate. The postoperative strength of gracilis was evaluated according to the BMRC score. The data were statistically analyzed. The difference was statistically significant if P<0.05. Results:The survival rate of 122 free gracilis transfers was 98.4% (120/122). Early complications occurred in 32 cases (including 2 complications in 6 patients) : 27 cases with recipient site complications (84.4%), 4 with donor site complications and 7 with systemic complications. Among the 32 cases of complications, 17 flap compromises caused by vascular obstruction and 15 of them were salvaged completely after exploration. Flap crisis was the main issue that affected the postoperative function of gracilis muscle, and 58.8% (10/17) of patients with vascular crisis showed muscle strength above M 3 after surgery. The main causes of vascular crisis were venous tortuosity and venous thrombosis, which had nothing to do with operation time and intraoperative blood loss. Conclusion:Flap crisis is the main factor affecting the postoperative function of gracilis. The rate of flap salvage can be tremendously increased by early detection, re-exploration and effective management of the flap crisis.

Objective To screen the potent permeation enhancers used in transcutaneous immunization with inactivated highly pathogenic avian influenza vaccine. Methods Five different permeation enhancers, ethanol, propylene glycol, dimethyl sulfoxide, ratinoic acid, oleic acid, were used to treat the skin of BALB/c mice before transcutaneous immunization. Sera were collected before the flist transcutaneous immunization and every two weeks post immunization. The titers of influenza virus-specific humoral IgG and IgA were assayed in serum, lung and nasal lavages by ELISA. The titers of hemagglutination inhibition ( HAI), IFN-γand IL-4 produced by splenic lymphocytes were also detected. Except that, clinical symptom of the skin in different time points and skin pathological changes were observed. Results The serum IgG titers, HAI titers and the influenza virus-specific lgA and IgG in lung and nasal lavages in the groups of HA +CT + DMSO, HA + CT + RA and HA + CT + OA were significantly higher than those of HA and HA + CT groups( P ＜0.05). Moreover, the numbers of splenic lymphocytes producing IFN-γ and IL-4 were increased in the above three groups than those in control groups. In addition, no evident clinical symptoms were observed, but stratum corneum of the skin in different groups showed different changes. Conclusion DMSO,RA and OA are potent permeation enhancers in mouse model inoculated with inactivated high pathogenic avian influenza vaccine transcutaneously.

BACKGROUND:The incidence of open fracture of the elbow joint is increased rapidly with an increased number of accidents. Fractures are often accompanied by severe soft tissue injuries. At present, a combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation for the treatment of open fractures has been widely reported. OBJECTIVE:To investigate the characteristics of the combined therapy of autologous skin grafting, vacuum sealing drainage, and external fixation for repair of complex and severe open fracture of the elbow joint. METHODS:A total of 41 patients with complex and severe open fracture of the elbow joint who received the combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation during January 2009 to December 2013 in General Hospital of Tianjin Medical University, China were selected. Al patients were treated with routine debridement, external fixation and vacuum sealing drainage to cover wound during the first period. During the second period, autologous skin grafting or flap transfer was used to repair wound when the fresh granulation tissue covered the wound. RESULTS AND CONCLUSION:The postoperative folow-up period of these 41 patients was 8-22 months, with an average period of 13 months. External fixation period was 8-13 months with an average period of 9.8 months. The open wounds were completely healed after autologous skin grafting or skin flaps transfer. Fractures were healed in 31 patients during the first period. There were 7 cases of delayed union, 3 cases of nonunion. Al fractures were completely healed during 8-12 months after iliac bone grafting. The excelent and good rate of limb function recovery was 73.1% among 41 patients with severe open fracture of the elbow joint. The limb function of Gustilo II patients better recovered. These results suggest that the clinical effect of the combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation for the treatment of complex and severe open fractures of the elbow joint is satisfactory.